Physician Focus: Listen to advice about hearing loss

What you should know about noise-induced hearing loss, from the doctors of the Massachusetts Medical Society.

Dr. Dennis S. Poe

As many as 10 million Americans have it. It usually happens slowly, and you may never know you're getting it. It occurs without pain, and it's permanent. As in forever.

It's noise-induced hearing loss (NIHL) - the slow loss of hearing caused by too much exposure to too much noise. And with so much noise around us these days - from lawn mowers, leaf blowers, snow throwers, motor vehicles, and even "personal listening devices" - protecting our hearing should be high on our list of health priorities. No treatment exists for noise-induced hearing loss.

Hearing aids may help, but they cannot restore your hearing. Here are some often-asked questions about the condition.

Q: How can I tell if I'm getting noise-induced hearing loss?

A: You may have NIHL if you experience any of the following: have trouble understanding what people are saying, particularly in crowded rooms; feel the need to raise the volume on radios and TVs; ask people to repeat what they're saying; or can't hear some sounds. You may also sense a ringing, sometimes constant, in your ears. This condition is called tinnitus, and can be of varying intensity and duration.

Q: Can noise really hurt my ears?

A: Yes. If it's loud enough, and you're exposed to it long enough. Once the cells and nerves of your inner ear (where the auditory or hearing nerves are located) are destroyed by repeated exposure to loud noise, hearing loss is permanent. The damage caused by noise is called sensorineural or nerve deafness. Noise-induced hearing loss is the second-most common cause of hearing loss, following loss due to aging.

Q: How can I tell if noise is dangerous?

A: People differ in reacting to noise. But if you have to shout over background noise to make yourself heard, if the noise hurts your ears or makes your ears ring, or if you have difficulty hearing for several hours after exposure to noise, your hearing may be damaged.

A: Because these devices let the user listen at high volumes, the potential for hearing loss exists if used for long periods. The type of earphone - earbuds or headphones - doesn't matter: the "worst" earphone is the one that's used at the highest volume for the longest time.

Q: Can I "toughen up" my ears to get accustomed to noise?

A: No. Once the damage is done, hearing loss is permanent. It bears repeating: No treatment, surgery, medicine, or device exists that can restore your hearing completely once it's damaged.

Q: Are different age groups more susceptible to noise-induced hearing loss?

A: All ages are susceptible, some to a greater degree than others. Teens are especially at risk from amplified music, either from personal listening devices, rock concerts or "boom boxes" in cars. Infants and toddlers may be harmed by loud toys, as their short arms hold toys close to their ears. And adults, with power tools like drills, saws and sanders, especially if used within closed spaces, are also at risk.

Q: How can I protect myself from noise-induced hearing loss?

A: Prevention is the best way. Avoid loud, prolonged noises whenever possible. Use hearing protection, like earplugs or mufflers, and keep them readily available. But use caution: all hearing protection is not created equal, and different kinds offer different levels of protection. Cotton in the ears offers no protection. Foam ear plugs reduce sounds about 15 to 25 dB, but earmuffs cut sounds even more, about 25 to 30 dB. Check the packages: the higher number, the more protection.

Q: Where can I learn more about hearing loss?

A: The American Academy of Otolaryngology at www.entnet.org, and the Sight and Hearing Association at www.sightandhearing.org are two sites with lots of patient-friendly information on ear health and hearing loss.

Dennis S. Poe, M.D. is a member of the Executive Board of the Massachusetts Society of Otolaryngology-Head and Neck Surgery and an ear, nose and throat physician at Children's Hospital in Boston. Readers should use their personal judgment when seeking medical care and should consult with their personal physician for treatment. Physician Focus is a public service of the Massachusetts Medical Society. You are welcome to e-mail comments to PhysicianFocus@mms.org.

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